title: Does CT evidence of a flat inferior vena cava indicate hypovolemia in blunt trauma patients with solid organ injuries?
abstract: BACKGROUND
  Nonoperative management for selective patients with solid organ injuries from blunt trauma has gained wide acceptance. However, for trauma surgeons, it is often difficult to estimate a patient's circulatory volume. Some authors have proposed that the presence of a collapsed inferior vena cava (IVC) on computed tomography (CT) scan correlates with inadequate circulatory volume. Our aim was to verify whether CT evidence of a flat IVC (FI) is an indicator of hypovolemia in blunt trauma patients with solid organ injuries.
  
  
  METHODS
  We conducted a retrospective chart review of all blunt trauma patients with solid organ injuries admitted to our Medical Center from July 2003 to September 2006. Of the 226 patients reviewed, 29 had CT evidence of FI. We compared Injury Severity Scores, hemodynamic parameters, fluid and blood transfusion requirements, mortality rate, and hospital course between patients with (FI group) and without FI (non-FI [NFI] group).
  
  
  RESULTS
  The FI group had higher rates of intensive care unit admission and mortality, in addition to longer intensive care unit stays, when compared with the NFI group. In addition, the patients in the FI group needed larger amounts of fluid and blood transfusions and presented lower hemoglobin levels during the first week of admission; furthermore, the majority deteriorated to a state of shock in the emergency department.
  
  
  CONCLUSIONS
  CT evidence of FI is a good indicator of hypovolemia and an accurate predictor for prognosis in trauma patients with blunt solid organ injuries.
authors.affiliation: Emergency Department , Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
authors.forename: Yu-Ying
authors.initials: YY
authors.lastname: Liao
authors.forename: Hung-Jung
authors.initials: HJ
authors.lastname: Lin
authors.forename: Yu-Hui
authors.initials: YH
authors.lastname: Lu
authors.forename: Ning-Ping
authors.initials: NP
authors.lastname: Foo
authors.forename: How-Ran
authors.initials: HR
authors.lastname: Guo
authors.forename: Kuo-Tai
authors.initials: KT
authors.lastname: Chen
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000328:Adult; D001803:Blood Transfusion / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D005440:Fluid Therapy; D006439:Hemodynamics; D017052:Hospital Mortality; D006801:Humans; D020896:Hypovolemia / Q000000981:diagnostic imaging*; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy